Once you leave the public health insurance, it ranges from very difficult to impossible to return. This prevents people from benefiting from low payments when they are young and switching only when their risks and payouts increase.
However, there are a few ways to return to the public system. It varies depending on whether you are an employee, are self-employed, have been exempt from compulsory insurance (earned more than EUR 60.750/yr.) or are over the age of 55.
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You go back to public health insurance from private health insurance in Germany if
Case 1: If you are an employee, the only way back to the public health insurance system is when your yearly income falls below the limit of less than EUR 60.750 (in 2019). To achieve this, you can ask your employer to reduce your hours or move some of your earnings into a pension scheme.
Case 2: If you are over 55 it is almost impossible. The only possibility is to join under the family program of your partner, and you can only do this if your own income is under 425 euro/mo.(or with a 450 euro mini job) as of 2017.
Case 3: If you are self-employed and under 55, you can change anytime as long as your income is below the EUR 60.750 limit. After 55, you have to retire to join the family program of your partner.
Case 4: If you work to move to another country and pay into a public health system, you can join the German public system on your return. However, this only applies to public insurance. If you have private insurance in Germany and in a foreign country, you must rejoin the private system when you return.
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